Provider Demographics
NPI:1114982238
Name:GULF MEDICAL SERVICES, INC.
Entity Type:Organization
Organization Name:GULF MEDICAL SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:R
Authorized Official - Last Name:STEBER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-438-7600
Mailing Address - Street 1:3103 N 12TH AVE
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32503-4006
Mailing Address - Country:US
Mailing Address - Phone:850-438-7600
Mailing Address - Fax:850-438-4138
Practice Address - Street 1:3103 N 12TH AVE
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32503-4006
Practice Address - Country:US
Practice Address - Phone:850-438-7600
Practice Address - Fax:850-438-4138
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-20
Last Update Date:2016-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHME112332B00000X
FLHME 112332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL026433400Medicaid
FL028315100Medicaid
FL8205961OtherUHC PROVIDER NUMBER
AL59087554OtherBCBS PROVIDER NUMBER
FL027405400Medicaid
FL028316900Medicaid
FLR6206OtherBCBS PROVIDER NUMBER
FLP8466OtherBCBS PHARMACY PROV NUM
FL0270070008Medicare NSC
FLR6206OtherBCBS PROVIDER NUMBER
FL8205961OtherUHC PROVIDER NUMBER
FL027405400Medicaid
FL0270070002Medicare NSC